Sometimes a great idea needs the forces of time and technology to come together in order to come to fruition. Consider the patient-centered medical home (PCMH)—or simply "medical home"—model. This is surely a case where time and technology are on the medical home’s side.

The medical home is one of the healthcare industry’s most discussed topics today. Its ability to foster collaboration among healthcare stakeholders centered on a holistic, patient-centric approach to care holds perhaps the best hope to transform and improve the system. Recent studies, for example, show that hospital readmissions of patients with chronic disease can be reduced by 46 percent for those in a transitional care management program, like the medical home.

However, the concept is not new. The Patient-Centered Primary Care Collaborative—one of the leading PCMH advocacy groups in the United States—credits the American Academy of Pediatrics (AAP) for first introducing the term "medical home" in 1967. The AAP initially coined "medical home" to refer to a single source of medical information about a patient. Eventually, the concept evolved to encompass the idea of building partnerships with families to ensure that primary healthcare is "…accessible, family-centered, coordinated, comprehensive, continuous, compassionate and culturally effective."

Forty years later, in March 2007, the sheer force of the times we live in came into play. A collective of the AAP, the American Academy of Family Physicians (AAFP), the American College of Physicians (ACP) and the American Osteopathic Association (AOA) released a document called "Joint Principles of the Patient-Centered Medical Home" describing the PCMH as "…an approach to providing comprehensive primary care for children, youth and adults. The PC-MH [sic] is a healthcare setting that facilitates partnerships between individual patients and their personal physicians, and when appropriate, the patient’s family."

This year, time, technology, and yes, legislation are converging to make the medical home a possibility. The Patient Protection and Affordable Care Act of 2010—otherwise known simply as "healthcare reform"—will bring unprecedented and sweeping changes to healthcare. Among them is a provision to reward providers for demonstrating the delivery of quality care. The law creates the Center for Medicare and Medicaid Innovation (CMI), which will test innovative payment and service delivery models. These models will support care coordination for patients through the use of a health information technology-enabled network, or health information exchange.

The law also creates a "shared savings program" that encourages redesigned care delivery processes for high quality and efficiency, which may be accomplished through the formulation of accountable care organizations (ACO). The federal government will release its working regulatory definitions of ACOs in 2011. Medical homes and ACOs have similar goals: higher quality care that is coordinated in a manner that leverages efficient business processes and evidence-based guidelines. The ACO model places the onus on providers to manage the costs associated with caring for their respective populations. As such, it might be considered both a healthcare delivery and business model. It has been said that medical homes can exist without ACOs, but ACOs can’t exist without medical homes. In some cases, ACOs have been defined as simply a collection of medical homes. The accuracy of either statement is open to debate, but the thinking behind them does illustrate the importance of the PCMH to the ACO concept.

While changes in reimbursement structure and practice transformation are the foundation of the medical home concept, technology stands as its greatest enabler. Here’s where time and technology meet. The ability we have now to combine powerful analytics with the right workflow tools; a health plan’s comprehensive, longitudinal patient data; and health information exchange capabilities is key to enabling an effective medical home model.

What do you think? Have time and technology converged to bring us to the point where an effective medical home can become a reality? Is the PCMH model the cornerstone of healthcare transformation?

We cover ‘The Patient-Centered Medical Home: The Cornerstone of Healthcare Transformation" in the new MEDecision Insights Series. I invite you to check it out at http://www.medecision.com/insightseries, and let us know your thoughts today.